CEO SUMMARY: Everything relating to automation in clinical laboratory operations was the theme of the sixth “International Conference of Laboratory Automation and Robotics,” conducted last month in Kobe, Japan. Because laboratories in Japan, Korea, and Taiwan have two and three decades of experience with extensive automation, presentations at this gathering are quite sophisticated and reveal that these laboratories are continuing to push forward in their use of automation.

ALMOST 300 LABORATORY DIRECTORS, PATHOLOGISTS, AND VENDORS gathered in Kobe, Japan, last month for the sixth “International Conference of Clinical Laboratory Automation and Robotics.”

Little-known in the United States and Europe, this meeting started in 1998 and takes place in April of every second year. Because this is the time when cherry blossoms are in full bloom across Asia, the conference is also known as the “Cherry Blossom Symposium.”

Japan is the world’s hotbed for the use of automation and robotics in clinical laboratories. A significant amount of the lab automation products sold throughout the world were developed in Japan and licensed to the world’s major in vitro diagnostics (IVD) manufacturers.

For that reason, this conference is a great help in understanding why clinical laboratories in the Far East have embraced lab automation for almost three full decades, in ways that frequently confound their counterparts in North America and Europe. That’s because hospital laboratories in Japan, Korea, Taiwan, and China commonly use total laboratory automation (TLA), along with fully-automated systems for pre-analytical functions and even automation of phlebotomy and specimen collection.

Conducted as a scientific meeting, each Cherry Blossom Festival is organized by a different group of pathologists and laboratory scientists from a host city. For 2008, the laboratory team at Kochi Medical School took the lead in hosting the events. Chairman of this sixth Cherry Blossom Symposium was Tetsuro Sugiura, M.D., who

is Professor and Head, Department of Laboratory Medicine at Kochi Medical School. Dr. Sugiura is recognized as one of the pioneers in laboratory automation in Japan. He and his colleagues proved to be great hosts and the symposium was chockfull of useful information and news about innovations in automation.

THE DARK REPORT was there to deliver a presentation, to participate in the sessions, and to conduct site visits of laboratories and IVD companies in Japan. Collectively, these experiences generated several useful insights for lab administrators and pathologists in Western countries. The experiences on this trip certainly advanced THE DARK REPORT’S thinking on laboratory automation and its future in developed countries across the globe, including the United States.

Lab Automation In Asia

One fact stands out about laboratory medicine in Japan, Korea, Taiwan, and China. Compared to the United States and most European countries, hospitals in Asia are typically large—and often have an attached outpatient clinic which treats thousands of patients daily. Thus, laboratories on this side of the world see patient volumes that dwarf the largest hospitals in the United States and Europe.

For example, in Seoul, Korea, the Asan Medical Center (AMC) at the University of Ulsan College of Medicine is a 2,800 bed facility. Its attached outpatient clinic will be treating 10,000 patients per day by the end of 2008! In 2007, the lab performed 30.9 million tests.

The lab’s goal at AMC was “one stop service,” meaning that “patients can visit his or her physician with test results as soon as possible in the same day after specimen collection.” Projects at AMC’s lab to accomplish this were presented by Won-kin Min, M.D., Ph.D., Professor of Laboratory Medicine at the Ulsan College of Medicine. Predictably, with the main lab’s analytical processes already automated, attention was given to specimen collection, specimen transport to the laboratory, and specimen processing in the laboratory. Dr. Min reported that projects to add another specimen collection room and another rapid response laboratory were under way to achieve the desired reduction in average lab test TAT.

Data Mining In The LIS

Use of information technology to advance laboratory medicine services is also occurring in Japan and surrounding countries. At the Yamaguchi University Graduate School of Medicine in Ube, Japan, Kiyoshi Ichihara, M.D., Ph.D. and his colleagues are using sophisticated software tools to data mine the laboratory test results in the laboratory information system (LIS). Ichihara, who is Professor, Department of Laboratory Sciences at Yamaguchi University, discussed a variety of ways to tease useful clinical knowledge from the lab test data residing in the LIS.

His goal is to develop a life style disease prediction system that, in part, can look at the results of unrelated lab test results and identify patterns consistent with disease, then proactively intervene with the patient to achieve positive health outcomes.

Visits To Sysmex And Labs

During this trip of nine days, THE DARK REPORT was also able to visit BML, Inc.’s main laboratory, located in a Tokyo suburb. It serves up to 150,000 patients per day and a report of that site visit was distributed as a Dark Daily e-briefing. We also had an executive briefing at the headquarters of Sysmex Corporation in Kobe, followed by a site visit to the Sysmex main manufacturing facility in Kakogawa. Another high point was our tour of the Tokyo University Hospital Laboratory. (See pages 5-7.)

Combined, participation at the Cherry Blossom Lab Automation Symposium and the site visits provided excellent information on why lab automation is so enthusiastically embraced in Japan and other Asian countries.